We’ve all heard of drunk in love. (Thanks, Beyoncé.) But what’s up with sleep drunkenness? This is a sleep disorder that can also be called “confusional arousal” and describes a sudden action or reflex upon waking up. In an episode, a sleeping person may wake up (or appear to wake up), but behave strangely and exhibit disoriented, unresponsive behavior. If they say anything, it probably won’t make much sense.
We’ll be using the terms “sleep drunkenness” and “confusional arousal” interchangeably in this article. Technically, “confusional arousal Stanford Health Care “Confusional Arousals” View Source ” is the official term for the condition—it’s the one you’ll find in most official literature on the topic—and “sleep drunkenness” is used more colloquially. Whatever you call it, the condition may affect as many as 1 in 7 adults, according to a Stanford study Stanford Medicine “"Sleep drunkenness" more prevalent than previously thought” View Source .
If you’ve ever woken up feeling all woozy (normal), talking funny (possibly also normal, depending on how tired you are), and your partner tells you it seems like you might have had a few too many while you were asleep (not so normal)—you’re not alone. Here’s what to know about sleep drunkenness, from its symptoms to causes, and what you can do to prevent it.
What Are The Symptoms of Sleep Drunkenness?
People who experience sleep drunkenness struggle with the transition between sleep and wakefulness. They may struggle to wake up fully and repeatedly fall back asleep. While they’re able to walk around, their conscious mind isn’t fully awake yet, which makes them say or do odd things.
Those who suffer from sleep drunkenness likely experience some or all of the following symptoms:
- Confusion after waking up
- Blunt responses and overactive reflexes Sleep Medicine Reviews “Waking up is the hardest thing I do all day: Sleep inertia and sleep drunkenness” View Source
- Slow speech and poor memory
- Brain fog throughout the day
These symptoms often last for just a few minutes, but sleep drunkenness can impact people for up to an hour after they wake. (And brain fog may last the whole day.) Much like someone who’s had too much to drink, people often can’t recall anything that’s happened from their sleep-drunk episode.
“In more severe cases, you could turn violent or aggressive when in this sleepy state. This can obviously be scary and sometimes dangerous for whoever you’re sleeping with,” says sleep specialist Carl Walsh. (It should be noted that this is very rare.)
If your partner feels that you should seek help for your sleep issues, look into visiting a sleep medicine specialist.
If you don’t identify with these symptoms, but struggle with waking up in the middle of the night, you might find this article more helpful.
What Causes Sleep Drunkenness?
Sleep drunkenness’ exact causes can be difficult to pinpoint. However, research shows that the following factors may be the culprit:
- Irregular sleep schedule or poor sleep quality (possibly due to rotating work shifts)
- Anxiety, bipolar, or post-traumatic stress disorder
- Daily stress
- Alcohol use Journal of Substance Abuse Treatment “Disturbed Sleep and Its Relationship to Alcohol Use” View Source
Research also shows that pre-existing conditions Parasomnias “Canadian Medical Association Journal” View Source or medication can be contributing factors causing sleep drunkenness, such as:
- Certain antidepressant use Neurology “Are confusional arousals pathological?” View Source
- Sleep apnea National Heart, Lung, and Blood Institute “What Is Sleep Apnea?” View Source
- Narcolepsy National Institute of Neurological Disorders and Stroke “Narcolepsy Fact Sheet” View Source
You should talk with a doctor (ideally one specializing in sleep medicine) to get to the root of any slumber trouble you’re having. When you do this, consider if any of the factors listed above apply to your life. This should make it easier for them to treat you.
Is Sleep Drunkenness Dangerous?
Regular, high-quality sleep is vital for overall health. Parasomnias are usually self-limiting, especially in young adults and kids. However if parasomnias are ongoing (especially in older adults) this can lead to poor quality (and quantity) sleep, which can affect your daily life and long-term health. Lack of sleep has been linked to heart problems Cureus “The Role of Circadian Misalignment due to Insomnia, Lack of Sleep, and Shift Work in Increasing the Risk of Cardiac Diseases: A Systematic Review” View Source and increases the risk Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. “Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders” View Source of diabetes, obesity, depression, and stroke.
If you have a sleep drunk episode once a year, it’s not a big deal. “For most people, sleep drunkenness just causes some mild confusion and strange behavior—often providing a laugh for whoever is waking you up,” according to Walsh. However, if it happens more frequently and it’s starting to cause issues in your day-to-day life, you should see a specialist. If you have recurring parasomnias that cause multiple awakenings at night as an adult, doctors will often look for an underlying cause and may order a sleep study. This is required to make a diagnosis.
If you experience any of the following in combination with sleep drunk episodes, it’s an especially good idea to visit a specialist:
- Missing work or sleeping on the job
- Friction in your relationships with your friends, family, or spouse
- Injuries caused by lack of concentration
- Persistent insomnia
How to Treat Sleep Drunkenness
There’s no quick fix for confusional arousal. Your best bet is to figure out the underlying cause of your disrupted sleep. To do this, you may need to get in touch with a sleep medicine doctor. You can also make some changes to your lifestyle that could be impacting your sleep, like sticking with a set bedtime and getting exercise during the day. (More on this in a bit.)
There isn’t currently an approved treatment for sleep drunkenness. It may be tempting to try to counter sleep drunkenness with an over-the-counter sleep aid like melatonin National Center for Complementary and Integrative Health “Melatonin: What You Need To Know” View Source . However, it’s best not to rely on this supplement, which is a synthetic version of the hormone the brain produces in darkness to cause a sleepy feeling. It can cause next-day grogginess American Sleep Association “Melatonin Side Effects” View Source , dizziness, and headaches, which likely won’t help with sleep drunkenness symptoms. Melatonin also hasn’t been studied enough to fully understand the effects of long-term use.
How to Get a More Restful Sleep
Sleep drunkenness is often a result of not-so-great sleep. Changing up your routine and upgrading your sleep environment can help alleviate some causes of sleep trouble.
Here are our favorite science-backed tips for better ZZZs:
1. Get sunlight during the day
How well you sleep at night actually starts with how you spend your day. Electric light and reduced exposure to sunlight can cause delays in your circadian rhythm Current Biology “Entrainment of the Human Circadian Clock to the Natural Light-Dark Cycle” View Source . In other words: Make sure you step outside every day and catch some sunlight—fresh air is good for your spirits and for your slumber.
2. Exercise every day
Even if it’s just a 20-minute walk, moving your body daily) increases the amount of deep sleep Johns Hopkins Medicine “Exercising for Better Sleep” View Source you get during the night and allows your body to rejuvenate. Just try not to do it right before going to bed (an hour or two beforehand is great). Otherwise, you may still have endorphins running through your system, which could make it hard to settle down.
3. Avoid eating too close to bedtime
A very full stomach can cause discomfort and make it more difficult to get a restful night of sleep International Journal of Environmental Research and Public Health “Does the Proximity of Meals to Bedtime Influence the Sleep of Young Adults? A Cross-Sectional Survey of University Students” View Source . The same goes for alcohol! It can cause snoring Sleep Medicine “Alcohol consumption and sleep problems in Hong Kong adolescents” View Source and increase your risk of sleep apnea Sleep Medicine “Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis” View Source which disrupts your night (and that of your partner if you don’t sleep alone).
4. Maintain a consistent sleep routine
Go to sleep and wake up around the same time every day. Yes, also on the weekends. After all, we’re creatures of habit, and maintaining a consistent sleep schedule will make it easier for you to fall asleep and wake up every day.
You should get at least seven to nine hours Journal of Clinical Sleep Medicine “Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society” View Source of sleep every night to avoid sleep debt Centers for Disease Control and Prevention “Sleep Debt” View Source , or the amount of sleep you need compared to how much you’re getting.
5. Remove sources of light from your sleep environment
This means no TV, no scrolling through TikTok on your phone, and no bright chargers or street lamps lighting up the room at night. If you can’t prevent the latter, wear an eye mask. This way, your sleep doesn’t get disrupted by blinking or blue light Harvard Health Publishing “Blue light has a dark side” View Source .
6. Install darkening shades
Blackout shades can block out any light from entering your room from the outside. If you’re worried about waking up in the morning, invest in an alarm clock that simulates a sunrise like the SmartSleep Lamp from Philips.
7. Reduce noise to a minimum
To anyone with roommates, a noisy neighborhood, or a cranky heating system: We know noise isn’t always in your control Sleep Science “Environmental noise and sleep disturbances: A threat to health?” View Source . But a fan or white noise machine can create consistent noise Sleep Medicine “The effects of white noise on sleep and duration in individuals living in a high noise environment in New York City” View Source , which is helpful for rest.
8. Keep it cool
Experts Cleveland Clinic “What’s the Best Temperature for Sleep?” View Source suggest that the best sleeping temperature is between 60 to 67 degrees Fahrenheit. If you can’t monitor your exact temp with AC, you can cool your room off by opening a window or getting a fan going. Otherwise, pay attention to what you’re wearing to bed—when the weather warms up, an old cotton T-shirt may be a better option than cozy flannel PJs.
9. Reserve the bedroom for sleep and romance only
Avoid doing stress-inducing activities in bed—like working, watching scary movies or TV shows, or trawling spooky Wikipedia articles—that could cause you to associate your bed with anxiety. Instead, consider reading a calming book, writing in a journal, or doing some meditation.
10. Keep a clear path to the bathroom
Ever hit your toe while trying to make your way to the bathroom at night? Yeah—not super restful. Make sure the path from your bed to the bathroom is clear, so you don’t have to turn the light on if nature calls in the middle of the night, and you don’t find yourself tripping over odds and ends.
In addition to causing potential grievous (or, at the very least, deeply annoying) pain, excess stuff can reduce your sense of calm.
11. Keep a journal by your bed
You know that thing when you’re just about to fall asleep—until you remember the text you forgot to respond to? Or the stressful meeting you have to lead tomorrow? Or that thing you put off today that you’re really not looking forward to catching up on tomorrow? If you find you’re dwelling on not-so-nice thoughts, try writing a to-do list Journal of Experimental Psychology “The effects of bedtime writing on difficulty falling asleep: A polysomnographic study comparing to-do lists and completed activity lists” View Source for the next day. A study of 57 young adults found that those who completed a to-do list before bed fell asleep faster than those who wrote down things they completed during the day.
Alternatively, you can save the journaling for when you wake up. Doing your morning pages (or stream-of-consciousness writing right when you wake up) may help with self-expression, processing emotion, and clearing your mind.
12. Get up and do a relaxing activity
If you can’t fall asleep within 20 minutes Sleep Foundation “What To Do When You Can't Sleep” View Source , get up and do something—maybe some yoga, maybe some reading. Yes, it sounds counterintuitive, but staying in bed can increase your stress levels and will only make it harder for you to get a good night’s sleep. If possible, leave your bedroom and do something relaxing or boring that makes you tired before returning to bed.
Sourcing
- “Sleep drunkenness” more prevalent than previously thought (Scope)
- Waking up is the hardest thing I do all day: Sleep inertia and sleep drunkenness (Sleep Med Rev.)
- Disturbed Sleep and Its Relationship to Alcohol Use (Subst Abus.)
- Parasomnias (CMAJ)
- Are confusional arousals pathological? (Neurology)
- Hypersomnia (Cleveland Clinic)
- Sleep Apnea (NIH—National Heart, Lung, and Blood Institute)
- Narcolepsy Fact Sheet (NIH—National Institute of Neurological Disorders and Stroke)
- The Role of Circadian Misalignment due to Insomnia, Lack of Sleep, and Shift Work in Increasing the Risk of Cardiac Diseases: A Systematic Review (Cureus)
- Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders (National Academies Press (US))
- The Four Chronotypes: Which One Are You? (Psychology Today)
- Chronotypes in the US – Influence of age and sex (PLoS One)
- Entrainment of the Human Circadian Clock to the Natural Light-Dark Cycle (Current Biology)
- Exercising for Better Sleep (Johns Hopkins Medicine)
